The quest for integrated health and social care: A case study in Canterbury, New Zealand

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This paper tells the story of the journey made by the District Health Board for Canterbury, New Zealand, towards its goal of providing integrated care for all. It looks at the drivers for change, the leadership values shown by key players and considers the lessons that can be learned from the Canterbury experience.

The changes made to the system since 2007 mean that Canterbury now has a system in which good-quality general practice is increasingly keeping patients who do not need to be in hospital out of it; is treating them swiftly once there; and discharging them safely to good community support.

Key findings

  • The stimulus for change in Canterbury was a health system that was under pressure and beginning to look unsustainable.
  • Canterbury adds to the small stock of examples of organisations and systems that have made the transition from fragmented care towards integrated care with a degree of measurable success.
  • Creating a new system takes time – Canterbury has been working to create ‘one system, one budget’ for at least six years and the journey is far from complete.
  • It takes many people to transform a system. A small number of leaders were at the heart of Canterbury’s transformation, but this leadership rapidly became collective, shared and distributed.

Policy implications

  • Those wishing to create a system of truly integrated health and social care must have a clear vision. In the case of Canterbury, the mantra 'one system, one budget' is firmly held and articulated.
  • Sustained investment is needed to provide staff and contractors with the skills needed to innovate and to support them when they do.
  • New forms of contracting may be needed. In Canterbury, this meant the price/volume schedule (the equivalent of the NHS tariff) was scrapped and the budgets for hospital departments were re-built from the base up.



Prime Healthcare Lmtd
Comment date
08 January 2018

Thanks for sharing important information. But now the revolution in healthcare service has been achieved. Technological automation makes medical service more efficient. The cloud-based computing system is using frequently. So to cope with the present era every healthcare service provider must have an integrated hospital management system likeathenaClinicals, Halogen TalentSpace for Healthcare, Veristream, bdtask HMS etc. this automation system helps ensure customer satisfaction & maximise profits.
Of course, Bill Gates expressed his vital thought: "The first rule of any technology used in a business is that automation applied to an efficient operation will magnify the efficiency. The second is that automation applied to an inefficient operation will magnify the inefficiency".

Roger Burns

Retired GP. NHSreality, owner,
Comment date
18 November 2013
It is better to have pragmatic and open rationing than covert and knee jerk rationing which differs so significantly across boundaries and from year to year that patients are completely unware of what goods and services are not available for them.
Patients ahve a right to know what is NOT covered.
Patients should be able to plan for what is not covered.
Comments and evidence are all expanded on

Murray Verbeek

Regional Director, Asia Pacific,
Imprivata Inc.
Comment date
26 September 2013
Canterbury District Health Board is a valued customer.

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